Corona Virus (Covid - 19)
Corona Virus ( Covid -19 ), the pandemic of 2020 has been the prevailing topic in this year 2020. There have been many theories regarding this disease which suddenly started in December in Wuhan, a city in china and spread to all around the world in no time. Whole world was devastated with it beginning with china itself, then America, Italy and now reached to India.
WHO declared on January 30th 2020 as a public health emergency of international concern.
The scientific studies say that, the corona virus that prevailed among animals from years and has been undergoing mutations.
Previously,
- SARS-COV : was identified in china 2003
- MERS-COV : was identified in Saudi Arabia in 2012
- SARS-COV2: now identified in Wuhan city of china in December 2019.
Agent and transmission: Corona ( Covid-19 )
This disease is caused by NOVEL CORONA VIRUS (earlier called as SARS-COV 2), now also called as COVID-19, which is a RNA virus of large size. It consists of a core of genetic material which is surrounded by a lipid envelope and protein spikes, which gives the appearance of a crown.
In Latin, crown is called as corona and this is how this virus gets its name.
The rapid spread of this virus from human to human is the matter of concern for which it was alarmed as PANDEMIC by WHO .
Mode of transmission : Majorly – droplet infection. But it can also spread by contact and formites.
Epidemiologist have said that the incubation period ( the infective period) is in the range of 2.2 to 11.5 days and in median of 5.1 days..
This spreads in all age groups , mostly in age >30yrs but as per some studies it is seen less common in children <10yrs.
Symptoms : fever( >100.4 F), cough , upper respiratory tract infection, shortness of breath, myalgia, headache, loss of smell and taste , gastrointestinal symptoms like nausea, vomitings , diarrhea along with this clinically hypoxia – SPO2 , 94%, tachycardia >10/min, respiratory distress ( RR >30/min) , hypotension ( systolic BP < 90 mmg), altered sensorium.
In some patients the cardiac injury markers increase , liver enzymes increase and there is lymphopenia (lymhocytes < 20) seen. CRP > 100 mg/dl , serum ferritin >300 microg/L , LDH >450 , D-Dimer > 1000 ng/ml.
CO MORBIDITIES ( Risk Factors - Corona (Covid-19))
The presence of co-morbidities is the main cause of deaths in the covid-19 positive patients. The people in risk are , the one who are above the age of 50yrs and who had any previous medical conditions like , diabetes, hypertension, lung diseases ( COPD/Asthma/post TB sequele), chronic kidney disease/chronic liver disease immune compromised /HIV/malignancy, obesity (the major leading problems of today’s sedentary life style).
INVESTIGATIONS - Corona (Covid-19)
The investigation of choice is RT-PCR. For which the most common specimen taken is nasopharyngeal swab.
Sensitivity order of the test is broncho alveolar lavage>sputum>nasal swab> nasopharyngeal swab
On positive for the test the base line investigations that are required are CBP,RBS,ECG, HbA1C (if diabetic), D-Dimer, LFT,CRP,IL6(if available), LDH, Serum ferritin, chest x-ray, CT chest
If starting on Tab. Favipiravir
- RFT
- Electrolyte if starting on tab.Favipiravir
- Uric acid
- If RT-PCR done please ask for replication score. It indicates how infective you are for other people. Any score above 25 is generally non-infectious especially if you have crossed 10 days and were asymptomatic for 3 consecutive days.
- The false negative rate of this test is 30%
- The other test that is mostly done in these days is the Rapid kit test which is based on the antigen test which has its own defaults like high false negative rate.
- As the scarcity of the test kits in the country has increased and majority of the treating doctors are left to rely on the clinical diagnosis and on the radiological imaging.
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